Medical Management of Pediatric Inflammatory Bowel Disease (PIBD) in the Asia Pacific Region: A Position Paper by the Asian Pan-Pacific Society for Pediatric Gastroenterology, Hepatology, and Nutrition (APPSPGHAN) PIBD Working Group

Lee WS 1 , Arai K 2 , Alex G 3 , Treepongkaruna S 4 , Kim KM 5 , Choong CL 1 Show all authors , Mercado KS 6 , Darma A 7 , Srivastava A 8 , Aw MM 9 , APPSPGHAN PIBD Working Group , Huang J 10 , Ni YH 11 , Malik R 12 , Tanpowpong P 13 , Tran HN 14 , Ukarapol N 15

Affiliations 

  • 1 Department of Paediatrics, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
  • 2 Center for Pediatric Inflammatory Bowel Disease, National Center for Child Health and Development, Tokyo, Japan
  • 3 Department of Gastroenterology and Nutrition, Royal Children's Hospital, Melbourne, Victoria, Australia
  • 4 Division of Gastroenterology, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
  • 5 Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea
  • 6 Makati Medical Center and The Medical City, Philippine Society for Pediatric Gastroenterology, Hepatology and Nutrition, Manila, Philippines
  • 7 Department of Child Health, Dr. Soetomo General Hospital, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
  • 8 Department of Paediatric Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
  • 9 Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
  • 10 Division of Paediatric Gastroenterology, Nutrition, Hepatology and Liver Transplantation, Department of Paediatrics, National University Hospital, Singapore
  • 11 National Taiwan University College of Medicine, Taiwan
  • 12 Department of Pediatrics, All India Institute of Medical Sciences (AIIMS), New Delhi, India
  • 13 Department of Pediatrics, Faculty of Medicine Ramathibodi, Mahidol University, Bangkok, Thailand
  • 14 Department of Gastroenterology, Children's Hospital # 1, Ho Chi Minh City, Vietnam
  • 15 Department of Pediatric Gastroenterology and Hepatology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
J Gastroenterol Hepatol, 2022 Dec 27.
PMID: 36574956 DOI: 10.1111/jgh.16097

Abstract

Pediatric inflammatory bowel disease (PIBD) is rising rapidly in many industrialised and affluent areas in the Asia Pacific region. Current available guidelines, mainly from Europe and North America, may not be completely applicable to clinicians caring for children with PIBD in this region due to differences in disease characteristics and regional resources constraints. This position paper is an initiative from the Asian Pan-Pacific Society for Pediatric Gastroenterology, Hepatology and Nutrition (APPSPGHAN) with the aim of providing an up-to-date, evidence-based approach to PIBD in the Asia Pacific region, taking into consideration the unique disease characteristics and financial resources available in this region. A group of pediatric gastroenterologists with special interest in PIBD performed an extensive literature search covering epidemiology, disease characteristics and natural history, management and monitoring. Gastrointestinal infections, including tuberculosis, need to be excluded before diagnosing IBD. In some populations in Asia, the Nudix Hydrolase 15 (NUD15) gene is a better predictor of leukopenia induced by azathioprine than thiopurine-S-methyltransferase (TPMT). The main considerations in the use of biologics in the Asia Pacific region are high cost, ease of access, and potential infectious risk, especially tuberculosis. Conclusion: This position paper provides a useful guide to clinicians in the medical management of children with PIBD in the Asia Pacific region.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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